VA, citing taxpayer savings, seeks open source EHR

By Mary Mosquera
04:22 PM
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The Veterans Affairs Department has started to move toward an open source model to modernize its acclaimed VistA electronic health record (EHR) system. 

VA expects to begin conversion to an open source iteration of VistA (Veterans Integrated Systems Technology Architecture) by summer, said VA Secretary Eric Shinseki in an April 1 announcement that it will release a draft document requesting vendors to offer proposals. 

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VistA’s legacy technical architecture makes for difficult and expensive maintenance and upgrades, VA said. Over the past year, VA has examined the implications for moving to open source for VistA and is convinced that it is the best model for veterans and taxpayers, said Roger Baker, VA CIO.  

“Our primary goal is to re-ignite the innovative processes that made VistA such a great EHR system. We also want to ensure that vendors of proprietary products can easily and confidently integrate their products with VistA to make them available for VA to purchase and use in our facilities,” he said in the VA announcement.

The department has pledged to deploy to all its facilities the open source version of VistA once it awards a contract for what it calls a custodial agent: an organization which has experience in establishing and operating an open source community, its processes and resulting products. 

As a participant of the open source community, albeit a large one, VA will contribute all non-security essential modifications to the product it makes or pays for to the open source custodian. Open source VistA will have public and private sector participants.

VA expects to award the one-year contract in June, according to the March 31 draft solicitation notice in Federal Business Opportunities. The department will publish the request for vendor proposals later this month.

In February, VA published documents seeking industry information about their expertise as open source custodial agents and also a proposal for the kinds of custodial services it would need.  

“This move towards open source welcomes private sector partners to work with us to improve VistA, and is an important part of our strategy to ensure that VA clinicians have the best tools possible, and that veterans receive the best health care possible," Shinseki said.

VA must accelerate the modernization of VistA, developed initially in the 1970s, even as it is collaborating with the Defense Department to come up with a common electronic health record. 

In a recent briefing, Baker said that as VA examined the open source model, it was influenced by both its work with the DOD for a joint EHR and by industry feedback about how to most easily integrate private sector technologies into the next version of VistA. 

Even in its updated form, VistA will still rely on its aging MUMPS code because it works, he said. The VistA system is available 99.95 percent of the time in VA hospitals and medical offices. 

VA expects that other organizations may want to use VistA Open Source, and welcomes their participation in the development, use and governance of VistA, said Peter Levin, VA chief technology officer.